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LECTURE NOTES
For Health Extension Trainees in Ethiopia
Introduction to Health Education
Meseret Yazachew
Yihenew Alem
Jimma University
In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center,
the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education
November 2004
Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00.
Produced in collaboration with the Ethiopia Public Health Training Initiative, The Carter
Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education.
Important Guidelines for Printing and Photocopying
Limited permission is granted free of charge to print or photocopy all pages of this
publication for educational, not-for-profit use by health care workers, students or
faculty. All copies must retain all author credits and copyright notices included in the
original document. Under no circumstances is it permissible to sell or distribute on a
commercial basis, or to claim authorship of, copies of material reproduced from this
publication.
©2004 by Meseret Yazachew Yihenew Alem
All rights reserved. Except as expressly provided above, no part of this publication may
be reproduced or transmitted in any form or by any means, electronic or mechanical,
including photocopying, recording, or by any information storage and retrieval system,
without written permission of the author or authors.
This material is intended for educational use only by practicing health care workers or
students and faculty in a health care field.
i
Acknowledgment
The development of this lecture note for training Health Extension
workers is an arduous assignment for Dr. Meseret Yazachew and
Dr. Yihenew Alem at Jimma University.
Essentially, it required the consolidation and merging of existing in
depth training materials, examination of Health Extension Package
manuals and the Curriculum.
Recognizing the importance of and the need for the preparation of the
lecture note for the Training of Health Extension workers THE
CARTER CENTER (TCC) ETHIOPIA PUBLIC HEALTH TRAINING
INITIATIVE (EPHTI) facilitated the task for Jimma University to write
the lecture note in consultation with the Health Extension
Coordinating Office of the Federal Ministry of Health.
Finally the Federal Ministry of Health would like to express special
words of gratitude for those who contributed and endeavored to the
development of this lecture note and to TCC/USAID for the technical
and financial support.
ii
Table of Contents
Content
Acknowledgement i
Table of content ii
List of abbreviations vi
List of tables vii
List of figures vii
Introduction ix
UNIT ONE: Introduction To Health Education
Objectives 1
Health Education 3
• Historical development 3
• Definitions 4
• Aims and Basic principles of Health Education 7
• Approaches to Health Education 10
• Targets for Health Education 10
• Health Education settings 11
• Who is responsible for Health Education? 11
• Role of Health Educator 12
Exercises 13
iii
UNIT TWO: Health And Human Behavior
Objectives 14
Introduction 14
Definition of behavior and other related terms 15
Factors affecting human behavior 17
The role of human behavior for prevention of disease 22
Exercise 25
UNIT THREE: Working With Communities
Objectives 26
Introduction 26
Definition of community 27
Concept of community participation 27
Benefit of community participation 30
Helping people to organize: The role of Health Extension
Workers 31
UNIT FOUR: Health Communication
Objectives 35
Introduction 35
What is communication? 36
Why communication? 36
Types of communication 37
iv
Components of communication 38
Communication stages 41
Common communication approaches 49
Methods of communication 49
Barriers to effective communication 51
Characteristics of effective communication 55
UNIT FIVE: Educational Methods And Materials
Objectives 57
Introduction 57
Educational methods 58
• Individual 58
• Group 63
Teaching materials 77
• Audios 77
• Visual aids 79
Mass media 84
Exercise 87
UNIT SIX: Training
Objectives 88
Introduction 88
What is training? 89
Types of training 89
Phases of training 89
v
Exercise 94
UNIT SEVEN: Planning, Implementation and Evaluation Of Health
Education Programs
Objectives 95
Introduction 95
Planning process 95
• Information gathering 97
• Defining and prioritizing problems 101
• Setting goals and objectives 103
• Identifying and obtaining resources 105
• Selecting appropriate methods 107
Carry out and evaluate the project 110
• Development and implementing a project plan 110
• Evaluating the project 111
Exercise 113
UNIT EIGHT: Ethical Issues in Health Education
Objectives 114
Introduction 114
Definition 114
Basic Principles of Ethics 115
Health extension workers responsibilities as a health educator .117
Exercise 119
vi
Reference: 120
vii
List of abbreviations
AIDS Acquired Immuno-Deficiency Syndrome
HE Health Education
HEWs Health Extension Workers
BCC Behavioral Change Communication
FGM Female Genital Mutilation
FP Family Planning
HIV Human Immunodeficiency Virus
HSDP Health Sector Development Program
IEC Information Education Communication
MOH Ministry of Health
PHC Primary Health Care
WHO World Health Organization
UNICEF United Nation Children’s Fund
viii
List of tables
Table 4.1 Examples of failure at different communication
• stages 47
Table 5.1.Main characteristics of mass media and face-to-face
communication 85
List of figures
Fig.2.1. Levels of prevention of disease 22
Fig.4.1. Complete communication model 38
Fig.4.2. Communication stages 42
Fig. 6.1 Project planning cycle 96
[...]... get doubt cleared • The health educator has to adjust his talk and action to suit the group for whom he has to give health education E.g when the health educator has to deal with illiterates and poor people, he has to get down to their level of conversation and human relationships so as to reduce any social distance • Health Education should provide an opportunity for the clients to go through the stages... chapter to serve as a self-test Lastly, we would be grateful and enthusiastic to receive any sort of feedbacks and comments on the writing x UNIT ONE Introduction To Health Education Objectives At the end of this chapter, the trainees will be able to: • Explain the concept of Health • Define Health Education • State historical development of Health Education • Describe objectives of Health Education. .. the health education of the community where the identification of problems and planning, implementing and evaluating are to be done with full involvement of the community to make it the community’s own program • Health Education is based on scientific findings and current knowledge Therefore a health educator should have recent scientific knowledge to provide health education • The health educators... Department of Health Education & Behavioral Sciences made utmost effort to produce the material within the shortest time possible We tried to include major topics on health education and promotion taking into account the scope of the beneficiaries and the essentiality of some titles The first two chapters deal with the concept and principles of health education and issues related to health and human... and health problems • Asking people to give their own ideas for solving the problems • Helping people to look as their ideas so that they could see which were the most useful and the simplest to put into practice • Encouraging people to choose the idea best suited to their circumstances 12 Exercise 1 Define health and health education? 2 Explain why voluntary actions are so important in health education. .. Education • State basic principles of Health Education Before discussing about health education, it is imperative to conceptualize what health itself means Health is a highly subjective concept Good health means different things to different people, and its meaning varies according to individual and community expectations and context Many people consider themselves healthy if they are free of disease... other harmoniously Mental health - ability to learn and think clearly A person with good mental health is able to handle day -to- day events and obstacles, work towards important goals, and function effectively in society Social health – ability to make and maintain acceptable interactions with other people E.g To feel sad when somebody close to you passes away The absence of health is denoted by such... to be planned in the light of the resources and organizational structures peculiar to each Thus, health education and promotion takes place, amongst other locations, in: • Communities • Health care facilities • Work sites • Schools • Prisons • Refugee camps …etc Who is responsible for health education? Health education is the duty of everyone engaged in health and community development activities Health. .. others to use this substance At the time of Alma Ata declaration of Primary Health Care in 1978, health education was put as one of the components of PHC and it was recognized as a fundamental tool to the attainment of health for all Adopting this declaration, Ethiopia utilizes health education as a primary means of prevention of diseases and promotion of health In 3 view of this, the national health. .. justified to persuade people to adopt specific behavior changes Targets for health education • Individuals such as clients of services, patients, healthy individuals • Groups E.g groups of students in a class, youth club • Community E.g people living in a village 10 Health education settings When considering the range of health education interventions, they are usually described in relation to different . of Health Education 7
• Approaches to Health Education 10
• Targets for Health Education 10
• Health Education settings 11
• Who is responsible for Health. The health educator has to adjust his talk and action to suit
the group for whom he has to give health education. E.g.
when the health educator has to
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